Ultrasound #4

First let me say, I have officially changed my doctors back to UCSD (where I had Elena).  I had my first appointment Monday with mid-wife Anne and I absolutely love her.  In one visit, I am amazed by the difference in care between the two hospital groups.  She gave me a lot of information, talked to me for awhile about what happened with Elena and told me how we will proceed with this baby taking into account my experience with Elena's delivery.  Since Elena had shoulder dystocia, I'm not allowed to give birth at the UCSD Birth Center again, I will be in the labor and delivery unit with a mid-wife and an OB.  She assured me that UCSD is trying to reduce their c-section rate so unlike my previous care providers, they are open to trying a natural delivery.  No medical waiver forms required!

Now that I've caught everyone up, on to the new business.  Friday we had our fourth ultrasound.  The baby was less than cooperative, above is the best picture we could get.  You are looking at a profile with an arm up, fist near the nose.  The baby was really low and facing down.  Despite my jumping, stretching, moving, peeing, this baby did not want to move out of it's little cocoon for the entire 2-1/2 hours we were there.  Signs of another independent, strong-willed child?

The remainder of this post is going to be more of a journal entry for my own memory, it may be more information then you'd like to know...if so feel free to skip the rest of the text and enjoy the picture above.

The ultrasound appointment was scheduled for 1 hour, we left 2-1/2 hours after our appointment began.  It was a long and exhausting afternoon.  When we had this ultrasound done with Elena, it was a completely different experience.  With Elena, we were in a nice cushy medical office.  The waiting room was full of patients and ultrasound was relatively quick (she was active and maybe a little bit further along).  This time, we were sent to the fetal genetics lab inside the hospital, complete with a hospital setting and very few patients waiting to be seen.  I suppose this should have been a red flag but I was so excited, it has taken a couple of days for everything to set in.  The set up was different because Anne has classified this pregnancy as a high risk.  Until Friday I thought it was just a high risk delivery due to the issues we had with Elena.  I guess high risk really means high risk and does not distinguish between pregnancy and delivery.

The purpose of this ultrasound was to see if the baby is developing correctly--neural tube closed, heart valves complete, blood flowing the correct way in and out of the heart, all limbs accounted for, and to verify the location of the placenta.  All seems to be good here.

One reason our appointment was so long was because the baby was not participating and they couldn't get all images of it's heart/blood flow.  Another reason was because they took extra time when they found a red flag.  The baby measures appropriately at 18-18.5 weeks, so around the 50-55th percentile.  The abdomen is much larger, measuring in at the 97th percentile which is of concern to the doctor.  Babies at this age tend to weigh right around 8 ounces, I've got a 10 ounce whopper!  After the ultrasound we spoke to Dr. Wolf, a perinatologist (mom-baby specialist).  Dr. Wolf put some things in perspective about my own PCOS insulin resistance and how that most likely impacted my pregnancy with Elena and is also impacting this baby's size.

When Dr. Wolf told us the news, my reaction was....but I'm eating so much better with this baby than I did my first.  Mind you, I didn't eat horribly with Elena but I was always hungry so always eating.  And I had my share of empty calories with Elena--ice cream, cookies, etc.  Sweets with this baby aren't as prominent, chocolate still doesn't taste right, not so big on cookies or ice cream.  I'm currently eating about 3 servings of fruit, minimizing breads, lots of protein and trying to increase my green leafy veggies per Anne's request.  I had noticed early in the pregnancy salads taste pretty good now, not usually a salad girl.  I may need to bring down my bread intake a little, but I'm already eating a fairly gestational diabetic friendly diet.

In an attempt to be optimistic, Dr. Wolf said it's better to have a bigger baby than one that is too small.  At least he can tell the placenta is working properly.  As Carl said, Dr. Wolf wasn't overly concerned.  Dr. Wolf will be in contact with Anne and has requested I come back for another ultrasound at 28 weeks to evaluate the baby's growth.  Opposite of Elena, this baby will be having a lot more ultrasounds.  I think Elena only had 3.  I will also have a scan at 36 weeks to evaluate my chances of having a natural childbirth.  Anne informed me that despite the results of the 36 week scan, it is my decision to try natural or opt for a c-section; though I already know if the tummy is too big, everyone pushes for a c-section--otherwise the belly may become lodged after delivering the hardest part, the head and shoulders. 

I will be going in for an early gestational diabetes test this week.  And then the regular glucose test at 24 weeks.  Hoping to have normal results for both tests.

To leave on a good note, occasionally, I have been able to feel baby movements on the outside of my tummy.  They just started yesterday and have been few and far between.  So far no one else has felt them...the movements are too quick and unpredictable.